Use of unidirectional endobronchial valves for the treatment of giant emphysematous bulla

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Visualization of bronchoalveolar fistula as the presenting sign of lung cancer

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Helicobacter pylori Induces Apoptosis of Human Monocytes but Not Monocyte-Derived Dendritic Cells: Role of the cag Pathogenicity Island

Monocytes are circulating precursors of the dendritic cell subset, professional antigen-presenting cells with a unique ability to initiate the innate and adaptive immune response. In this study, we have investigated the effects of wild-type Helicobacter pylori strains and their isogenic mutants with mutations in known bacterial virulence factors on monocytes and monocyte-derived dendritic cells. We show that H. pylori strains induce apoptosis of human monocytes by a mechanism that is dependent on the expression of a functional cag pathogenicity island. This effect requires an intact injection organelle for direct contact between monocytes and the bacteria but also requires a still-unidentified effector that is different from VacA or CagA. The exposure of in vitro-generated monocyte-derived dendritic cells to H. pylori stimulates the release of inflammatory cytokines by a similar mechanism. Of note is that dendritic cells are resistant to H. pylori-induced apoptosis. These phenomena may play a critical role in the evasion of the immune response by H. pylori, contributing to the persistence of the infection

F-18-2-Fluoro-2-Deoxyglucose Positron Emission Tomography Compared to Technetium-99m Hexakis-2-Methoxyisobutyl Isonitrile Single Photon Emission Chest Tomography in the Diagnosis of Indeterminate Lung Lesions

Background: (18)FDG-PET plays a significant role in diagnosing malignancy of lung lesions but remains an expensive test available at a limited number of sites in Italy. Objective: We prospectively compare the diagnostic accuracy of (99m)Tc-MIBI-SPECT and (18)FDG-PET in patients with indeterminate lung lesions to demonstrate that (99m)Tc-MIBI-SPECT may be considered as a valid alternative when (18)FDG-PET is not available. Methods: 52 patients with indeterminate lung lesion were examined by (18)FDG-PET and (99m)Tc-MIBI-SPECT before surgery. The scintigraphic findings were analyzed visually and semiquantitatively and then correlated to the definitive diagnosis. Results: 38 were malignant lesions while 14 were benign. At visual analysis, the sensitivities of (18)FDG-PET and (99m)Tc-MIBI-SPECT were 92 and 84%, respectively (McNemar test p = 0.4), whereas the specificities were 78.6 and of 93% (p = 1.0), respectively. At semiquantitative analysis, (18)FDG-PET showed a sensitivity and specificity of 92 and 71.4%, respectively, while (99m)Tc-MIBI-SPECT produced a sensitivity and specificity of 86 and 100%, respectively (p = 0.194). For lymph node staging, (18)FDG-PET and (99m)Tc-MIBI-SPECT have a sensitivity and specificity of 88 and 92 of 77 and 100%, respectively. Conclusion: (99m)Tc-MIBI-SPECT is similar to (18)FDG-PET in the detection of lung malignancies and represents an alternative when PET is not available. Yet, the combination of both techniques may improve patient selection for surgery. Copyright (C) 2010 S. Karger AG, Base